多西他赛联合PD-1抑制剂对晚期非小细胞肺癌预后及血清MMP-9、TIMP-1水平的影响

Clinical Efficacy of Docetaxel Combined with PD-1 Inhibitor on the Prognosis and MMP-9 and TIMP-1 in Advanced Non-small Cell Lung Cancer

目的探讨多西他赛联合程序性死亡受体1(PD-1)抑制剂对晚期非小细胞肺癌(NSCLC)预后及血清基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶组织抑制剂-1(TIMP-1)水平的影响。方法将90例晚期NSCLC患者随机分为研究组和对照组,每组45例。对照组给予多西他赛和顺铂治疗,研究组在对照组治疗基础上给予PD-1治疗,3周为1个治疗周期,共治疗6个周期。比较2组治疗后客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)、总生存期(OS),观察2组治疗期间不良反应发生情况及治疗前后血清MMP-9、TIMP-1水平的变化。结果研究组治疗后DCR、PFS、OS显著高于对照组(P<0.05);治疗期间2组不良反应发生率比较差异无统计学意义(P>0.05);2组治疗后血清MMP-9、TIMP-1水平较治疗前显著降低(P<0.05),且研究组降低较对照组更为显著(P<0.05)。结论多西他赛联合PD-1抑制剂对晚期NSCLC具有较好的疗效和预后,能够降低血清MMP-9、TIMP-1水平,降低肺癌细胞侵袭转移的能力,安全性良好。

Objective To investigate the effects of docetaxel combined with programmed death receptor 1(PD-1)inhibitor on the prognosis and the levels of serum matrix metalloproteinase 9(MMP-9)as well as tissue inhibitor of matrix metalloproteinase 1(TIMP-1)in advanced non-small cell lung cancer(NSCLC).Methods 90 patients with advanced NSCLC were randomly divided into the study group and the control group,45 cases in each group.The control group was given docetaxel and cisplatin treatment,and the study group was further given PD-1 treatment,with 3 weeks as 1 treatment cycle and a total of 6 cycles of treatment.Objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS),and overall survival(OS)were compared between the 2 groups,and the occurrence of adverse reactions during the treatment period and the changes of serum MMP-9 and TIMP-1 levels before and after the treatment were observed in the 2 groups.Results The DCR,PFS and OS of the study group were significantly higher than those of the control group after treatment(P<0.05);the difference in the incidence of adverse reactions between the 2 groups during the treatment period was not statistically significant(P>0.05);the levels of serum MMP-9 and TIMP-1 in the 2 groups after treatment were significantly reduced compared with those before treatment(P<0.05),and the reduction in the study group was more significant than that in the control group(P<0.05).Conclusion Docetaxel combined with PD-1 inhibitor might have better clinical efficacy and prognosis in advanced NSCLC.It can reduce serum MMP-9 and TIMP-1 levels,and attenuate the invasion and metastasis ability of lung cancer cells,with good safety profile.